Metro Manila (CNN Philippines, August 4) — The Commission on Audit (COA) questioned the validity of claims covered by the Philippine Health Insurance Corporation (PhilHealth) for RT-PCR tests amounting to ₱8.2 billion from 2020 to 2022.
In its latest report on PhilHealth uploaded to its website on Friday, the COA said the agency paid for over 2.4 million RT-PCR tests conducted by its partner contractor even though the claims were not supported by properly accomplished case investigation forms (CIFs).
Auditors noted that the issue of incomplete documentation of RT-PCR tests was already flagged in the audit of PhilHealth for 2020 and 2021.
“Despite having the audit issue raised in the previous audits emphasizing the necessity of the submission of the CIFs, 100 percent of the forms remain either partially or not fully filled out,” the audit body said.
The COA recommended that PhilHealth submit the properly accomplished CIFs to support the flagged claims to avoid audit suspension or disallowance.
The PhilHealth management, meanwhile, explained that there were challenges in collecting properly filled out CIFs, especially at the height of the COVID-19 pandemic.
“The central objective of this partnership was to effectively address the challenges posed by the pandemic and safeguard the well-being of the population,” PhilHealth said.
Still, the agency said it has communicated to its partner contractor that claims with improperly accomplished CIFs will no longer be accepted.
